Anaesthesia and intensive care
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We endeavored to thoroughly review Greek mythology and collect tales dealing with anaesthesia and myochalasis (paralysis). Among the evaluated sources were the poems of Hesiod, the epics of Homer, the tragedies of the great Athenian poets (namely Aeschylus, Sophocles and Euripides) as well as the contributions of several Latin writers, including Ovid. We found several examples of achieving hypnosis, analgesia and amnesia through the administration of drugs (inhaled or not) and music. ⋯ We noted that providing sleep was considered a divine privilege, although several mortals (mainly women) exhibited such powers as well. The concepts of sleep and death were closely associated in ancient classical thought. This review may stimulate anaesthetists' fantasy and may help them realise the nobility of their medical specialty.
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Anaesth Intensive Care · Jul 2012
Case ReportsLong-term use of nerve block catheters in paediatric patients with cancer related pathologic fractures.
We report three cases of children with osteosarcoma and pathologic fractures treated with long-term continuous nerve blocks for preoperative pain control. One patient with a left distal femoral diaphysis fracture had a femoral continuous nerve block catheter for 41 days without complications. ⋯ The third patient, whose right proximal humerus was fractured, had a brachial plexus continuous nerve block catheter for 36 days without complication. In our experience, prolonged use of continuous nerve block is safe and effective in children with pathologic fractures for preoperative pain control.
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Epidural volume extension is a technical modification of the combined spinal epidural block. It involves the epidural injection of normal saline or a small volume of local anaesthetic after an intrathecal injection, aiming to augment the post-spinal sensory level. Although the consequent sensory block augmentation has been adequately documented, the probable factors influencing epidural volume extension and its implications for clinical practice are not well defined. This article reviews published literature relating to the probable factors affecting epidural volume extension, its clinical implications, case reports of its successful clinical application and summarises its unexplored effects.